Thoughts And Articles From Tracy Green, Attorney At Green and Associates, Who Represents Professionals, Businesses and Individuals In Administrative, Criminal Defense, Regulatory, Health Care and Civil Litigation Matters In California

Friday, July 24, 2009

Case Dismissed Against Orange County Doctor Charged With Insurance Fraud Relating To Alleged Work Related Injury At Kaiser

POST-SCRIPT - CASE DISMISSED

Back in July 2009, I wrote about a physician who had been arrested. The DA's Office issued a press release when the case was filed. However, they did NOT file a press release when the case was dismissed on December 28, 2009. The case was dismissed after the physician showed substantial evidence of her chronic pain conditions and that she would likely prevail at trial. This case is evident why it is critical to evaluate all evidence in the case and be prepared to defend a case. This criminal filing could have ruined the physician's career but the dismissal not only prevented a conviction but any Medical Board action as well.

ORIGINAL POST

On July 21, 2009, physician Maryam Bahramfarsi was arrested and charged with 10 felony counts of making fraudulent statements and representations to fraudulently collect insurance in Orange County Superior Court Case No. 09CF1651. Dr. Bahramfarsi is being accused of claiming a hospital work-related injury that left her unable to sit, stand, or walk, with the intention of committing insurance fraud. This case is being prosecuted by the Orange County District Attorney’s Office.

A felony complaint contains allegations that a defendant has committed a crime. Every defendant including Dr. Bahramfarsi is presumed innocent until and unless proven guilty.

Dr. Bahramfarsi worked as a physician for Kaiser Permanente Medical Center in Aliso Viejo. On July 10, 2007, Dr. Bahramfarsi is accused of calling the name of a medical assistant from an examination room, where she was found laying on the floor. She is accused of claiming that she was unable to get up after slipping on an oily substance on the floor and falling on her lower back and neck. Between July and December 2007, Dr. Bahramfarsi is accused of visiting two doctors claiming to be suffering from severe pain as a result of her fall.

She is accused of complaining that the pain made her unable to sit, stand, or walk for more than five minutes at a time, and telling the doctors that she spent most of her time lying on her side in bed. Dr. Bahramfarsi is accused of claiming that all the prescribed pain medication and physical therapy was not effective, and that she was unable to sleep or rotate her body due to the pain. She is accused of arriving to several of the doctors’ appointments in a wheelchair, stating that she was in constant pain and was unable to walk or stand for more than 10 minutes. She is accused of claiming that she had trouble finding rides to make it to her appointments.

She is also being accused of being placed by doctors on modified work restrictions, but failing to return to work at all after Kaiser Permanente was unable to accommodate her restricted terms. Various examinations, x-rays, MRIs, and bone scans allegedly detected no abnormalities and offered no explanation as to the pain from which Dr. Bahramfarsi claimed to be suffering.

This case arose after Kaiser Permanente hired an investigative service to conduct surveillance of Dr. Bahramfarsi on three occasions between September and November 2007. While unknowingly being observed and videotaped, Dr. Bahramfarsi is accused of participating in physical activities such as sitting, standing, and walking, which she had claimed to doctors she was unable to do as a result of her injury from falling at work.

Under surveillance, Dr. Bahramfarsi is accused of carrying two 1-gallon jugs of water and placing them in the trunk of her car without apparent struggle. She is accused of walking and carrying items to and from a gravesite at El Toro Memorial Park, standing to clean a grave, and stepping onto and off of a step stool while cleaning and decorating the grave and a tree above it. On one occasion, she is accused of driving herself to a doctor’s appointment, getting out of her car without visible trouble, and then being pushed in her wheelchair by a male companion into the doctor’s office. Dr. Bahramfarsi is also accused of repeatedly entering and exiting her car without apparent restriction to her movement and driving and sitting for extended periods of time.

This seems like a defensible case since a physician must have examined her and certified her as disabled. There is also a difference in being able to sit for hours at a time and to sit at all. This appears to be criminalization of a dispute over a work injury.

Any questions or comments should be directed to: tgreen@greenassoc.com. Tracy Green is a principal at Green and Associates in Los Angeles, California. They focus their practice on the representation of licensed professionals, individuals and businesses in civil, business, administrative and criminal proceedings. They have a specialty in representing licensed health care providers. Their website is: http://www.greenassoc.com/

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